The impact of TMS and PNS frequencies on MEP potentiation in PAS with high-frequency peripheral component

Paired associative stimulation (PAS) combines transcranial magnetic stimulation (TMS) and peripheral nerve stimulation (PNS) to induce plastic changes in the corticospinal tract. PAS employing single 0.2-Hz TMS pulses synchronized with the first pulse of 50-100 Hz PNS trains potentiates motor-evoked...

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Bibliographic Details
Published in:PloS one 2020-05, Vol.15 (5), p.e0233999-e0233999
Main Authors: Mezes, Magdolna, Havu, Roope, Tolmacheva, Aleksandra, Lioumis, Pantelis, Mäkelä, Jyrki P, Shulga, Anastasia
Format: Article
Language:English
Subjects:
Biology and Life Sciences
Care and treatment
Development and progression
Evoked potentials
Experiments
Laboratories
Magnetic brain stimulation
Magnetic fields
Medical imaging
Medical research
Medicine and Health Sciences
Motor evoked potentials
Neurosciences
Observations
Patient outcomes
Peripheral nerves
Plasticity
Potentiation
Pyramidal tracts
Research and Analysis Methods
Spinal cord injuries
Transcranial magnetic stimulation
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Summary:Paired associative stimulation (PAS) combines transcranial magnetic stimulation (TMS) and peripheral nerve stimulation (PNS) to induce plastic changes in the corticospinal tract. PAS employing single 0.2-Hz TMS pulses synchronized with the first pulse of 50-100 Hz PNS trains potentiates motor-evoked potentials (MEPs) in a stable manner in healthy participants and enhances voluntary motor output in spinal cord injury (SCI) patients. We further investigated the impact of settings of this PAS variant on MEP potentiation in healthy subjects. In experiment 1, we compared 0.2-Hz vs 0.4-Hz PAS. In experiment 2, PNS frequencies of 100 Hz, 200 Hz, and 400 Hz were compared. In experiment 3, we added a second TMS pulse. When compared with 0.4-Hz PAS, 0.2-Hz PAS was significantly more effective after 30 minutes (p = 0.05) and 60 minutes (p = 0.014). MEP potentiation by PAS with 100-Hz and 200-Hz PNS did not differ. PAS with 400-Hz PNS was less effective than 100-Hz (p = 0.023) and 200-Hz (p = 0.013) PNS. Adding an extra TMS pulse rendered PAS strongly inhibitory. These negative findings demonstrate that the 0.2-Hz PAS with 100-Hz PNS previously used in clinical studies is optimal and the modifications employed here do not enhance its efficacy.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0233999